Fees Based on 2017 Value for Service

Fees Subject to Change

  • Extra charge for Saturday appointments, when available: $100 value
  • Charge for before 8.30 AM or after 5:00 PM appointments: $100 value
  • No-shows and late cancellations: $100 – $200
  • In-office blood draw fee and specimen handling for specialized labs: $50 – $100
  • At-home or office blood draw and specimen handling: $125 – $175
  • Fee for medical excuse forms – School, Work, Airlines, Jury Duty: $75
  • Disability forms, case by case: $100+
  • Refill request without appointment, when medically appropriate: $25
  • Urgent refill authorization over the weekend: $35
  • Assistance with prior authorization for special medications, anesthesia, imaging, and procedures: $50
  • Correspondence with other practitioners regarding Treatment & Health-Care Operations: Physician’s Hourly Rate
  • Courtesy scheduling of outside tests & services and facilitating referrals: $25
  • Provision of medical records or letter of medical necessity (when needed) to assist vendors/labs getting paid and reduce patient liability: $25 – $50
  • Late request (more than a week after the visit) for provision of special receipt (“superbill”) with pertinent codes for reimbursement to patient/subscriber, PPO patients only: $10
  • Shipping charges. Actual fee will be passed on to the patient. This charge is not covered by Support and Convenience Programs
  • Handling charges waived when enrolled in Support and Convenience Programs: $10 – $25
  • Drop off charge when our office staff needs to make a special trip to drop off a FedEx, DHL, UPS, USPS or other types of mail package: $25 – This charge is not covered by Support and Convenience Programs
  • Medical inquiries (online, patient portal, fax, phone, etc.) that do not require formal office evaluation or dedicated time for counseling: $45+ per inquiry
  • Medical inquiries that require a dedicated consultation time: Fee is based on 10-minute increments
  • Review of alternative plans or other information that patient might have learned through Internet or other sources: Physician’s Hourly Rate
  • Medical records on CD, excluding shipping fee: $25
  • Faxing medical records (limited number of pages) to non-healthcare providers: 10 cents per page + $10 handling fee
  • Patient Portal brief consultation: $45. Please see “Online Communication, Rules of Engagement”
  • Request for creating a Lab Requisition prior to or after a visit: $45
  • Transcription fee for transfer of information from email to medical records: $15 per email